| NPI | 1710071238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA PARKER RANDOLPH Director 910-762-3118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL065013) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-02-12 |